Usability and Acceptability of Web-Based Alcohol and Drug Screening, Brief Intervention, and Referral to Treatment for Survivors of Sexual Assault and Intimate Partner Violence: A Mixed-Methods Investigation (Preprint)

Abstract

Sexual assault (SA) and intimate partner violence (IPV) survivors are at high risk for alcohol and drug misuse. SA/IPV survivors face barriers to services for alcohol and drug misuse and have low service utilization rates. One avenue for increasing access to services in this population is the use of web-based screening, brief intervention, and referral to treatment (SBIRT), an evidence-informed approach for early identification of alcohol and drug misuse, and connecting individuals to treatment.

The present mixed-methods study assessed the usability and acceptability of a web-based SBIRT intervention called Choices for your Health After Trauma (CHAT) tailored to address alcohol and drug misuse following past year SA and/or IPV.

Phase 1 involved gathering feedback about usability and acceptability from focus groups with victim service professionals (VSPs; n=22) and interviews with past-year IPV/SA survivors (n=13). Phase 2 involved gathering feedback about the acceptability of an adapted version of CHAT in an additional sample of recent IPV/SA survivors (n=17). Survey data on past year and lifetime SA/IPV history, posttraumatic stress disorder (PTSD) symptoms, alcohol and drug use, and service use were collected from survivors in both phases to characterize the samples. Using a deductive coding strategy, qualitative analyses of interviews and focus group data were conducted using a coding template analysis comprised of six themes determined a priori (usability, visual design, user engagement, content, therapeutic persuasiveness, and therapeutic alliance).

Six themes emerged during focus groups and interviews related to CHAT: Usability, Visual Design, User Engagement, Content, Therapeutic Persuasiveness, and Therapeutic Alliance. Phase 1 providers and survivors viewed CHAT as acceptable, easy to use/understand, and helpful. Participants reported that the intervention could facilitate higher engagement in this population as the online modality is anonymous, easy to access from many devices, and brief. Participants also offered helpful suggestions for improving CHAT by updating images, increasing content personalization, reducing text, and making users aware that the intervention is confidential. The recommendations of Phase 1 participants were incorporated into CHAT. Phase 2 survivors viewed the revised intervention and also found it highly acceptable (M=4.1 out of 5; SD=1.29). Four themes encapsulated participant’s favorite aspects of CHAT: Content/Features, Accessible/Easy to Use, Education, and Personalization. Six survivors denied disliking any aspect. The themes on recommended changes included: Content/Features, Brevity, Personalization, and Language Access. Participants provided dissemination recommendations.

Overall, CHAT was acceptable among SA/IPV survivors and VSPs and may be beneficial to integrate into services for people with alcohol and drug misuse after SA/IPV. Findings support recommendations to develop approaches that address interpersonal violence and alcohol and drug misuse simultaneously. Positive reactions to CHAT show promise for future research investigating CHAT’s efficacy.

N/A